Organization
LILLY WILEN M.D. A MEDICAL CORPORATION
Active
Other names
New Concepts Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
LILLY WILEN M.D. (OWNER)
(818) 831-3227
Entity
Organization
Contact information
Practice address
17075 DEVONSHIRE ST, SUITE 306, NORTHRIDGE, CA 91325-1600
(818) 831-3228
(818) 831-3447
Mailing address
17075 DEVONSHIRE ST, SUITE 306, NORTHRIDGE, CA 91325-1600
(818) 831-3227
(818) 831-3447
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A61876
CA
Other
Enumeration date
01/15/2007
Last updated
01/05/2012
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